Chapter 4: Dopamine Fasting

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Okay, so we've got some really interesting stuff to dive into today.

And I know a lot of you have sent in some sources that have you thinking about why we consume what we do, how we get stuck in those patterns and how we can maybe start to shift them.

Yeah, it's a question we all grapple with in one way or another, isn't it?

Absolutely.

And today we're gonna try and unpack a framework that might offer some helpful insights into this whole thing.

It's called, get ready for it,

dopamine.

I love a good acronym.

And this one is particularly good because it's not just about what we typically think of as addiction, drugs and alcohol.

It could really apply to anything we might be overdoing.

Right, it's about anything that gives us that surge of dopamine and how our brains then react to that, like picture a seesaw, right?

Okay, I'm picturing it.

So on one side, we've got pleasure, maybe even like amplified pleasure from something we're using as a replacement reward, something we lean on to get that good feeling.

But then on the other side, we've got these like nagging feelings, almost like little gremlins pulling us down towards all those negative consequences, you know?

I get it, like we're trying to get that seesaw back into balance because ultimately when we overuse something, it can really tip the scales towards pain in the long run.

Exactly, and that's where this dopamine acronym comes in.

It's like our roadmap, each letter a step in this process of understanding and hopefully changing these patterns.

It gives us a structured way to look at something that can feel pretty complex.

Right, so let's break it down.

Okay, the D is for data.

And this first stage is all about just gathering the facts.

Nitty gritty.

Exactly, just laying it all out.

No judgment, no analysis yet.

One of the sources we got had this great example with a teenage girl, Delilah.

Her parents brought her in because they were concerned about her cannabis use.

And right away we see why getting that detailed data is so important because for Delilah, she felt like the bigger issue was her anxiety, not necessarily the cannabis itself.

But of course, they're likely interconnected in some way, right?

Yeah, and that's what we're trying to figure out.

And she was really specific about her use too, which I thought was interesting.

She started out with blunts and bongs, even differentiating between sativa during the day and indica for the evening.

Wow, so she had a whole system.

She did.

And then it went even further into concentrates.

Wax, oil, butter, shatter, even some terms I wasn't familiar with, like scissor, dust,

and QY soap.

QY soap, that's a new one for me too.

Right, so her main way of using it at that point was a vape pen, sometimes a volcano, and then edibles every now and then.

So you really get a sense of her daily habits, you know?

And this level of detail is crucial for understanding the true pattern of consumption.

Totally, and this source points out that this is actually a pretty significant change from how cannabis was used, say, back in the 60s.

More of a weekend thing recreationally.

Now we're seeing a lot of patients with this pattern of daily use, even all day use, which this source connects with the likelihood of addiction.

Makes sense.

The more you do something, the more potential for it to become problematic.

And this source even included a personal example that really resonated with me.

At one point I realized I was spending hours, sometimes whole days, just lost in romance novels, which made me realize this dopamine framework, it can apply to things we might not typically think of as addictive.

Oh, for sure.

I mean, we all have our things, right?

Right, exactly.

So once we've got the data, the O is for objectives, and here we start to explore the why.

Why is someone using this substance, engaging in this behavior?

What are they trying to achieve, even if it's not conscious?

And the source makes this great point that often even behavior that seems irrational on the surface usually has an underlying logic to it.

So understanding that why, it's crucial.

It is, and when they asked Delilah why she smoked, her answer was so revealing.

She said, it's the only thing that works for my anxiety.

Without it, I'd be non -functional.

I mean, even more non -functional than I am now.

And that really highlights the function it served for her, even if it also had negative consequences.

Yeah, and I think that asking about objectives in this way kind of validates that positive role the substance or behavior plays, at least from the person's perspective.

And it opens up a space for understanding rather than judgment.

It does.

The source lists some common objectives, and it's a pretty wide range, like fun, fitting in, relieving boredom, but also managing things like fear, anger, anxiety, insomnia, depression, inattention, pain, even social phobia.

So many different motivations.

And for you, with the romance novels, what was your objective there?

Well, you know, thinking back, it was really about escaping a tough time.

My kids were becoming teenagers, and I was feeling a bit lost, honestly.

And there was this sadness around not having another baby, which was causing some tension in my marriage.

So those books, they were like a temporary escape from all of that.

I can see that.

So we've got the data, the what, and the objectives, the why.

Now we move on to the P, which is for problems.

Right, the downsides, those unintended consequences that inevitably come along with these high dopamine activities.

And when they first asked Delilah about the problems with her smoking, she just said it was her parents, you know, that if they'd back off, there wouldn't be any problems.

Oh, wow, classic teenager.

Right, right.

And it's interesting, the source mentions she seemed physically healthy despite the heavy use.

I guess that's that youthful resilience.

Right, but that doesn't last forever.

The source makes this really important point that high dopamine activities, they always lead to problems eventually, whether it's health,

relationships, morality, something.

And the hard part is that it's often tough to see these downsides while you're still engaged in the behavior.

It is.

And the source explores a couple of reasons why that is.

One is that these substances, these behaviors, they can cloud our ability to accurately see cause and effect.

I love this quote from the neuroscientist Daniel Friedman.

He says, our world is sensory rich and causal poor.

Like we immediately feel that pleasure of say biting into a donut, but the longer term consequences like gaining weight, they're not so immediately apparent.

Right, and on that note, younger people often have a greater tolerance for negative consequences, at least initially.

The source even mentions high achieving students who can still function while smoking pot daily, but that often shifts as we get older.

Definitely, I mean, think about it.

A lot of people who voluntarily seek treatment, they're middle -aged.

It's that point where the downsides finally outweigh the perceived benefits.

They're sick and tired of being sick and tired, as they say.

Exactly.

And even with teenagers, the source suggests that just knowing others disapproves can sometimes be a motivator for change.

But ultimately, stopping, even temporarily, that's the key to seeing those cause and effect relationships clearly.

So we've got data, objectives, and problems.

Now we come to the A in dopamine, which is for abstinence.

This is where we actually stop the high dopamine substance or behavior for a period of time.

Right.

And with Delilah, the suggestion was to abstain from cannabis for a whole month.

They explained this was important for a couple of reasons.

First, it would give any anxiety treatments a chance to work without interference.

And second, it would help determine if the cannabis itself was contributing to her anxiety.

And you know, teenagers, there was a little pushback, right?

She asked if a week would be enough, said she'd done that before.

But the source emphasizes that it usually takes at least a month for the brain's reward system to reset.

So even if her anxiety didn't improve, that would still be valuable information.

Yeah, it helps to rule things out.

And what's interesting is how the conversation shifted when they started talking about her future self.

Like, did she want to still be using cannabis in the same way a year from now?

And when she realized she didn't, that seemed to be the turning point.

Makes you think, right?

And the source explains that this abstinence period, it's really about restoring homeostasis, that internal balance.

It lets our ability to experience pleasure from normal, everyday things come back online.

Think of it like those gremlins on the seesaw finally taking a break.

And the seesaw can level out.

I like that visual.

And the source even brings in some brain science here.

It mentions Nora Volkow's research, which showed that even after two weeks of stopping drug use, dopamine transmission in the brain is still below normal.

So two weeks often isn't enough.

And you might still be experiencing withdrawal symptoms.

Right, and there's this other study by Mark Schuckett that looked at men who were heavy drinkers and also had depression.

And the findings were pretty amazing.

After four weeks without alcohol, 80 % of them no longer met the criteria for clinical depression.

80%, that's huge.

It is.

And while there might've been other factors at play, like being in a supportive hospital environment, the fact that 80 % responded compared to the usual 50 % with standard depression treatments, it's pretty significant.

Makes you think about the connection between the two.

And the source does point out that the length of abstinence needed can vary.

Some people might need less than four weeks, others longer.

It depends on things like the potency of the substance, how much they were using, how long they've been using it.

In their age,

younger brains tend to bounce back quicker.

Oh, and the specific substance itself matters too, because withdrawal can be so different.

Absolutely, and this is a really important point.

The source really emphasizes that you should never suddenly stop using things like alcohol, benzodiazepines, or opioids if you've been using them heavily.

Medically supervised withdrawal is crucial in those cases.

It can be life -saving, for sure.

And the source also touches on how just replacing one high dopamine activity with another, it's not really effective.

It's like cross -addiction, where anything rewarding enough can potentially become problematic.

Right, and if you're used to those big dopamine hits, normal pleasures might not even register anymore.

It's like your baseline has shifted.

And here's another important thing.

About 20 % of people, they don't actually feel better after abstaining.

And that can tell us something important, like maybe the substance wasn't the main driver of their mental health issues.

Maybe there's something else going on.

So important to figure that out.

Okay, we've gone through data, objectives, problems, and abstinence.

Next up in our dopamine framework is M for mindfulness.

And this is where we prepare for those uncomfortable feelings that can come up during abstinence.

Right, because, let's be honest, it's not always easy.

They actually advised Delilah to expect to feel worse before feeling better, like that initial anxiety from withdrawal on top of her usual anxiety.

And they said there's often a turning point around the two -week mark.

Interesting, and when she asked about taking medication to help with the discomfort, they made this really insightful point.

There aren't really any non -addictive medications that can just erase that kind of pain, so the goal becomes learning to tolerate it.

Which is where mindfulness comes in.

The source actually calls it an opportunity to observe ourselves, to see our thoughts and emotions and physical sensations, even the unpleasant ones, without getting swept away by them.

It's like taking a step back and becoming the observer.

Exactly, and mindfulness, they define it as simply noticing what our brain is doing without judgment,

which, let's be real, is harder than it sounds.

We're talking about the brain observing itself.

Whoa, meta, and they use this cool analogy about observing the Milky Way, seeing our thoughts and feelings as separate from us, but still part of us.

I love that, and the non -judgment part is so important because, let's face it, our brains can come up with some pretty weird stuff sometimes, but if we judge those thoughts, we can't really observe them clearly.

And they even share a personal story about having an intrusive thought about harming a baby, which is like every parent's worst nightmare.

But through mindfulness, they were able to see that it came from a place of fear, not an actual desire to harm, and that led to self -compassion.

Wow, that's so powerful.

It is, and this practice of mindfulness, it's especially important in early abstinence.

So many of us use these high dopamine activities to distract ourselves from uncomfortable feelings.

So when we take that away, those feelings, they can come rushing back.

Like they've been bottled up and suddenly they're free.

Right, and the source suggests that instead of running from those feelings, we need to learn to be with them.

And when we do that, it can actually make our experience richer, more nuanced.

The pain might still be there, but it somehow feels less overwhelming.

Less isolating maybe, like we're not alone in it.

Exactly, and the source even talks about feeling this existential dread during a time when they were abstaining from reading.

It just goes to show that even seemingly small changes can trigger anxiety.

But through mindfulness, there was this gradual loosening of those mental boundaries, this increased awareness, and this realization that it was possible to just be present in the moment without constantly needing to escape.

Okay, so we've covered data, objectives, problems, abstinence, and mindfulness.

That brings us to the I in dopamine, which stands for insight.

And with Delilah, her transformation after that month of abstinence was pretty remarkable.

It really was, her skin was glowing, her posture was better, she had this genuine smile, but the internal changes were even more profound.

She said her anxiety was gone.

Wow, and she described those first few days of withdrawal, feeling blah, even throwing up, but she actually saw those symptoms as a sign of her dependence, which motivated her to keep going.

It's like reframing those tough moments into something positive.

But what's really striking is how she described feeling afterwards.

So much better, less anxious, clearer mind, no more worrying about her parents smelling cannabis, less anxiety at school.

The paranoia disappeared too, and she talked about the relief of not constantly having to plan her next high.

Not to mention saving money, and she started enjoying things she used to do sober, like spending time with her family.

Right, all those things we take for granted.

And then she had this realization, this huge aha moment, she said, Doctor, I'm telling you the truth, I did not see weed as a problem.

I really didn't see it.

But now that I've stopped smoking, I realize how much smoking was causing anxiety instead of curing it.

Five years of continuous use, and it took that month off to really see it clearly.

That's so powerful.

And that's the essence of this eye stage, isn't it?

Abstaining gives us this clarity that's just not possible when we're still caught up in the behavior.

Absolutely.

So with that newfound insight, we move on to N, which is for next steps.

What happens after that period of abstinence?

What are the goals moving forward?

Right, and with Delilah,

the question was whether she wanted to stay abstinent or try to go back to using cannabis in a different way.

And her initial response was really telling.

She said, being sober, I'm the best version of me.

But she also missed that creative feeling and that sense of escape.

So it seems like she wanted to find a way to use less.

Which brings up this ongoing debate in the addiction field.

Can people with a history of problematic use ever go back to moderate, non -harmful use?

The source mentions the traditional AA view, which is that abstinence is the only safe path for people with addiction.

But they also point to some newer research suggesting that for some people, especially those with less severe use patterns, controlled use might be possible.

And in my own experience, I've seen that happen too.

It's not always black and white, is it?

And that brings us to the final letter in dopamine, the E, which stands for experiment.

So now we've got this potentially reset dopamine system, a plan in mind, and we go back out into the world.

And whether the goal is continued abstinence or like Delilah trying moderation, it's all an experiment.

Totally, it's about figuring out what works for you.

Trial and error.

But there's a big caveat here, especially for people who have struggled with more severe addiction.

Moderation, it can backfire.

Sometimes it leads to a rapid return to old patterns after abstaining, that abstinence violation effect.

Oh, right, where you feel like, well, I already messed up, might as well keep going.

And the source talks about these rat studies, which are pretty fascinating.

Rats predisposed to addiction, they would often binge on alcohol or high calorie foods after a period of abstinence.

And that binge effect was less pronounced in rats that weren't prone to compulsive behavior.

So the question is, is this binge effect specific to things that provide calories, or is it more about that underlying predisposition we don't really know yet?

Right, more research needed.

And even when moderation is possible, the source points out that a lot of people find it too exhausting in the long run and choose abstinence instead.

Which makes sense.

It's like constantly having to be on guard.

And then there's this whole other question of how do we even moderate things like food or smartphones, things we can't really abstain from completely?

Right, they're everywhere.

And the source emphasizes how important it is to figure out moderation in this world, where we're constantly bombarded with high dopamine temptations, these digital drugs, like smartphones.

I think they're gonna talk more about strategies for moderation in a future episode.

Oh, I hope so.

But the main point is, this whole dopamine fast process, it's about getting back to a state of balance, restoring our natural ability to experience pleasure from all sorts of things.

Yeah, rediscovering those simple joys.

So in this deep dive, we've really explored this dopamine framework as a way to understand and potentially change how we relate to those high dopamine activities in our lives.

And Delilah's story was a great example of this process in action.

From gathering that initial data, understanding her motivations, acknowledging the problems, experimenting with abstinence, using mindfulness to cope, gaining those crucial insights, considering her options, and approaching it all as an ongoing experiment.

And that leaves us with a final thought for you, our listener.

As you've been listening to this discussion, what areas of your own life might benefit from this kind of examination?

Even if you don't feel like you have a classic addiction, it's worth thinking about your own pleasure pain balance and how those high dopamine activities might be affecting it.

And with that, we can confirm that we've covered all the key points from the source material in this deep dive.

Thanks for joining us.

Until next time.

Bye.

Bye.